Siatkowski R M, Capó H, Byrne S F, Gendron E K, Flynn J T, Muñoz M, Feuer W J
Bascom Palmer Eye Institute, University of Miami, Florida.
Am J Ophthalmol. 1994 Sep 15;118(3):343-50. doi: 10.1016/s0002-9394(14)72959-9.
We performed a retrospective chart review of 100 patients with idiopathic orbital myositis, who were of ages 9 to 84 years. Data from 75 patients gave the following results. Females were affected more than twice as often as males. Fifty-one patients (68%) had single muscle involvement, with the lateral and medial recti affected most frequently (38 cases [33%] and 33 cases [29%] of muscles, respectively). In 34 patients (45%), affected muscles functioned normally; the remaining 55% (63 muscles) were fairly equally distributed between paretic (20%), restrictive (20%), or combined paretic and restrictive (15%) myopathies. Analysis of muscle function, echographic findings, and duration of symptoms indicates that within days of onset of symptoms, the affected muscle is initially enlarged but retains normal function. Within the first two weeks, continued enlargement results in muscle paresis. The muscle may then enter a partially or completely restrictive phase, which may become permanent. Fifty-one patients (68%) responded well to systemic corticosteroids, although 11 patients (15%) had further recurrences of the disease. Seven patients (9%) later developed thyroid eye disease after initially having unimuscular orbital myositis. We advocate early institution of corticosteroids in order to avoid permanent restrictive myopathies.
我们对100例年龄在9至84岁之间的特发性眼眶肌炎患者进行了回顾性病历审查。75例患者的数据得出了以下结果。女性受影响的频率是男性的两倍多。51例患者（68%）有单块肌肉受累，其中外直肌和内直肌受累最为频繁（分别为38例[33%]和33例[29%]）。34例患者（45%）受累肌肉功能正常；其余55%（63块肌肉）在麻痹性（20%）、限制性（20%）或麻痹性与限制性合并（15%）肌病之间分布相当均匀。对肌肉功能、超声检查结果和症状持续时间的分析表明，在症状出现后的几天内，受累肌肉最初会肿大，但仍保持正常功能。在最初两周内，持续肿大导致肌肉麻痹。然后肌肉可能进入部分或完全限制性阶段，这可能会成为永久性的。51例患者（68%）对全身用皮质类固醇反应良好，尽管11例患者（15%）疾病有进一步复发。7例患者（9%）最初患有单肌性眼眶肌炎，后来发展为甲状腺眼病。我们主张早期使用皮质类固醇以避免永久性限制性肌病。
